| NPI | 1629317904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 70075) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C. 1000485) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2013-02-06 |